Depression, lifestyle factors and cognitive function in people living with HIV and comparable HIV‐negative controls. Issue 4 (8th February 2019)

• Record Type: Journal Article
• Authors: De Francesco, D; Underwood, J; Bagkeris, E; Boffito, M; Post, FA; Mallon, PWG; Vera, JH; Williams, I; Anderson, J; Johnson, M; Sabin, CA; Winston, A
• Other Names: Babalis Daphne investigator.; Burgess Laura investigator.; Mallon Paddy investigator.; Sachikonye Memory investigator.; Asboe David investigator.; Garvey Lucy investigator.; Pozniak Anton investigator.; Clarke Amanda investigator.; Bexley Andrew investigator.; Richardson Celia investigator.; Kirk Sarah investigator.; Gleig Rebecca investigator.; Bracchi Margherita investigator.; Pagani Nicole investigator.; Cerrone Maddalena investigator.; Bradshaw Daniel investigator.; Ferretti Francesca investigator.; Higgs Chris investigator.; Seah Elisha investigator.; Fletcher Stephen investigator.; Anthonipillai Michelle investigator.; Moyes Ashley investigator.; Deats Katie investigator.; Syed Irtiza investigator.; Matthews Clive investigator.; Fernando Peter investigator.; Chiwome Chido investigator.; Hardwick Shane investigator.; Mguni Sifiso investigator.; Clark Rebecca investigator.; Nevin‐Dolan Rhiannon investigator.; Pelluri Sambasivarao investigator.; Campbell Lucy investigator.; Yurdakul Selin investigator.; Okumu Sara investigator.; Pollard Louise investigator.; Santana‐Suarez Beatriz investigator.; Macken Alan investigator.; Ghavani‐Kia Bijan investigator.; Maher Joanne investigator.; Byrne Maria investigator.; Flaherty Ailbhe investigator.; Babu Sumesh investigator.; Otiko Damilola investigator.; Phillips Laura investigator.; Laverick Rosanna investigator.; Beynon Michelle investigator.; Salz Anna‐Lena investigator.; Severn Abigail investigator.; Tembo Lavender investigator.; Stott Matthew investigator.; McDonald Linda investigator.; Dransfield Felix investigator.; Whitehouse Andrew investigator.; Ngwu Nnenna investigator.; Hemat Nargis investigator.; Jones Martin investigator.; Carroll Anne investigator.; Kinloch Sabine investigator.; Youle Mike investigator.; Madge Sara investigator.;
• Is Part Of: HIV medicine. Volume 20:Issue 4(2019)
• Page Start: 274
• Page End: 285
• Publication Date: 2019-02-08
• Subjects: cognitive disorder -- cognitive function -- depression -- HIV -- HIV‐associated neurocognitive disorders -- people living with HIV; HIV infections -- Treatment -- Periodicals; HIV-positive persons -- Periodicals; HIV infections -- Treatment -- Decision making -- Periodicals; 616.9792
• DOI: 10.1111/hiv.12714
• Languages: English
• ISSNs: 1464-2662

Abstract

Abstract : Objectives: We investigated whether differences in cognitive performance between people living with HIV (PLWH) and comparable HIV‐negative people were mediated or moderated by depressive symptoms and lifestyle factors. Methods: A cross‐sectional study of 637 'older' PLWH aged ≥ 50 years, 340 'younger' PLWH aged < 50 years and 276 demographically matched HIV‐negative controls aged ≥ 50 years enrolled in the Pharmacokinetic and Clinical Observations in People over Fifty (POPPY) study was performed. Cognitive function was assessed using a computerized battery (CogState). Scores were standardized into Z ‐scores [mean = 0; standard deviation (SD) = 1] and averaged to obtain a global Z ‐score. Depressive symptoms were evaluated via the Patient Health Questionnaire (PHQ‐9). Differences between the three groups and the effects of depression, sociodemographic factors and lifestyle factors on cognitive performance were evaluated using median regression. All analyses accounted for age, gender, ethnicity and level of education. Results: After adjustment for sociodemographic factors, older and younger PLWH had poorer overall cognitive scores than older HIV‐negative controls ( P < 0.001 and P = 0.006, respectively). Moderate or severe depressive symptoms were more prevalent in both older (27%; P < 0.001) and younger (21%; P < 0.001) PLWH compared with controls (8%). Depressive symptoms ( P < 0.001) and use of hashish ( P = 0.01) were associated with lower cognitive function; alcohol consumption ( P = 0.02) was associated with better cognitive scores. After further adjustment for these factors, the difference between older PLWH and HIV‐negative controls was no longer significant ( P = 0.08), while that between younger PLWH and older HIV‐negative controls remained significant ( P = 0.01). Conclusions: Poorer cognitive performances in PLWH compared with HIV‐negative individuals were, in part, mediated by the greater prevalence of depressive symptoms and recreational drug use reported by PLWH.